Provider Demographics
NPI:1265513048
Name:TRIHEALTH PHYSICIAN INSTITUTE
Entity type:Organization
Organization Name:TRIHEALTH PHYSICIAN INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY-BOARD MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6386
Mailing Address - Street 1:PO BOX 631914
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1914
Mailing Address - Country:US
Mailing Address - Phone:513-569-5027
Mailing Address - Fax:513-569-5199
Practice Address - Street 1:10496 MONTGOMERY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5223
Practice Address - Country:US
Practice Address - Phone:513-745-2358
Practice Address - Fax:513-745-1405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIHEALTH PHYSICIAN INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0064268Medicaid
OH0064268Medicaid